Take this Quick Survey and receive a $25 Seminar Gift Card! Start

Dr. Dimitrios-Kostopoulos, P.T., Ph.D., D.Sc.
Hands-On Seminars - The Leader In Manual Therapy Continuing Education And Publications
Manual Therapy Training Education Seminars Classes Courses Publication Books
Seminar Information & Registration
Toll Free 888-767-5003
International 212-246-4066

Admin Login
Manual Therapy Training Education Seminars Classes Courses Publication Books
Hands-On Seminars - The Leader In Manual Therapy Continuing Education And Publications
View Current Newsletter - Manual Therapy Horizons     

To Learn More About Our Hybrid Courses Call Us At 888-767-5003

Kinesio Taping Practitioner Certification (CKTP) Program Vestibular Rehabilitation course
Mastery Certification in Manual Therapy (MCMT) Learn and Lead. Click here for details.


Dr. Dimitrios Kostopoulos & Konstantine Rizopoulos, along with their organizations Hands-On Seminars & Hands-On Physical Therapy support research initiatives in the area of Manual Therapy & Rehabilitation. Both companies have an annual allocated budget to support research initiated by employees and associates of our organizations.

At the same time we support research initiatives by the American Physical Therapy Association and the International Myopain Society.

Dr. Kostopoulos is Associate Editor of the Journal of Bodywork and Movement Therapies and Hands-On Seminars endorses it. A brief sample of articles from this journal is provided here .

Here are some of the articles published by our associates:

Improving posture: Comparing Segmental Stretch and Muscular Chains Therapy

José Luís Pimentel do Rosário, Inês Yoshie Nakashima, Konstantine Rizopoulos, Dimitrios Kostopoulos, Amélia Pasqual Marques
Clinical Chiropractic 10 January 2013 (Article in Press DOI: 10.1016/j.clch.2012.10.039)

Muscular Chains Therapy (MCT), which uses postural positions for global stretching, and Segmental Stretch Technique (SST), which stretches one muscle at a time, are two static stretching techniques currently used to improve, correct and treat postural imbalances. Aiming to identify which of these two techniques is most effective in order to improve standing posture, 30 women between 21 and 30 years old were evaluated and divided into three groups of 10 participants each: The SST group, the MCT Group and the Control Group (CG). Postures were evaluated before and after treatment through digital photographs. After transferring the images to the computer, tracings were made with Corel Draw software using six marked anatomical points: intertragic notch; anterior part of the lateral border of the acromion; suprasternal notch; posterior superior iliac spine (PSIS); anterior superior iliac spine (ASIS); the inferior angle of the scapula; and right lateral malleolus. The two experimental groups underwent eight sessions of stretching, twice a week, for about 30 min each session. The MCT Group was found more effective (p < 0.05) than the SST and CG in the variables ASIS (p = 0.001), PSIS (p = 0.001) and acromion (p = 0.001). No statistically significant differences were found in postural variables scapula, acromion-line and line-intertragic notch. In conclusion, the MCT stretching was superior to the SST in treating postural deviations.

View full article

Points of Clarification: Delineating the distinction between acupuncture and dry needling for trigger-point pain

By Dimitrios Kostopoulos, PT, MD, PhD, DSc, ECS, and Konstantine Rizopoulos, PT, DPT, MCMT

Two instrument-assisted means of treating chronic pain conditions due to MyoFascial Trigger Points are acupuncture and trigger-point dry needling. Unfortunately, many therapists confuse the terms acupuncture and dry needling, or use the terms interchangeably. However, a clear and definitive distinction exists between the two modalities, and a distinction must be made to avoid confusion. Hands-On Seminars founders Dr. Kostopoulos and Dr. Rizopoulos expand the horizon of understanding of these techniques by explaining the differences in a thorough manner.

Delineating the distinction between acupuncture and dry needling for trigger-point pain



Trigger Point Dry Needling is an effective approach for the treatment of MyoFascial Trigger Points. Dr. Kostopoulos and Dr. Rizopoulos have learned, researched, practiced and taught this very effective approach for many years. The Federation of State Boards of Physical Therapy - FSBPT as well as the American Physical Therapy Association - APTA published their position papers supporting the use of Dry Needling by Physical Therapists.

It is the view of Hands-On Seminars that Dry Needling is a therapeutic modality that fits within the scope of the physical therapy profession. We encourage PT programs to include dry needling as part of their undergraduate teaching curriculum. Hands-On Seminars and its founders offer courses in Dry Needling.

FSBPT Intramuscular Manual Therapy Dry Needling Resource Paper

APTA Dry Needling Resource Paper


Trigger Points: An Elusive Foe

Teaching myofascial trigger point therapy for over 18 years to more than 30,000 therapists worldwide, Dr. Kostopoulos and Dr. Rizopoulos have come to realize that while therapists treat myofascial trigger points, many of them successfully, few of them have a deeper understanding of the pathophysiology of a myofascial trigger point. With this article the worldknown experts provide a summary of various mechanisms responsible for the genesis of myofascial trigger points.

Trigger Point Article Advance


Effect of topical aerosol skin refrigerant (Spray and Stretch technique) on passive and active stretching.

Dimitrios Kostopoulos PT, PhD, DSc, MCMT and Konstantine Rizopoulos PT, FABS, MCMT .

This study was sponsored by St. Matthew’s University School of Medicine.


Objectives: The purpose of this study was to examine the effects of the use of a vapocoolant blend of pentafluoropropane and tetrafluoroethane (Gebauer's Spray and Stretch) on hip flexion stretching.

Methods: Thirty volunteers were randomly assigned to spray and stretch treatment and stretch only control groups. Each group was assessed pre- and posttest on passive and active hip flexion range of motion (ROM).

Results: Findings indicated greater posttest hip flexion gains for the spray and stretch group over the stretch only group for both active and passive ROM. Additionally, females achieved greater pre- and posttest differences on active ROM compared to males.

Conclusions: Study findings suggest that spray and stretch techniques can be an effective treatment in increasing hip flexion ROM.


Nerve conduction velocities in the lower extremity in patients with Raynaud's phenomenon and clinical applications

Dimitrios Kostopoulos PT, PhD, DSc, Konstantine Rizopoulos PT, FABS and Nikolaos Vartholomeos PT, DPT


Background and purpose: The purpose of the study is to study the nerve conductivity of the tibial motor, peroneal motor, peroneal sensory, and sural nerves in patients with primary and secondary Raynaud's phenomenon (RP).

Subjects: Twenty each: primary RP, secondary RP, and normal controls.

Methods: Electromyography using distal latency (DL) and nerve conduction velocity (NCV) as dependent variables.

Results: Peroneal nerve DLs were slower and NCVs were weaker for the secondary RP group compared to the primary RP group and controls. Tibial motor nerve DLs from slowest to fastest were: primary RP, secondary RP, and controls. NCV strength order was: secondary RP weakest, primary RP, and controls.

Discussion: Patients with secondary RP generally had the slowest DLs and the weakest NCVs, with differences most pronounced in the motor nerves. With the exception of the tibial motor nerve, patients with primary RP had similar NCVs to the control group. Neural mobilization techniques can be applied to assist with patient symptoms.


Treatment of carpal tunnel syndrome: a review of the non-surgical approaches with emphasis in neural mobilization

Dimitrios Kostopoulos

Abstract: Carpal tunnel syndrome (CTS) results from the entrapment of the median nerve at the wrist. It is the most common entrapment syndrome causing frequent disability especially to working populations. Aside from the surgical release approach there are other non-invasive therapeutic methods for the treatment of CTS. This paper will review the evidence regarding neurodynamic testing and neuromobilization of the median nerve as a treatment approach to CTS.


Reduction of Spontaneous Electrical Activity and Pain Perception of Trigger Points in the Upper Trapezius Muscle Through Trigger Point Compression and Passive Stretching

Dimitrios Kostopoulos, PT, PhD, DSc
Arthur J. Nelson, Jr., PT, PhD
Reuben S. Ingber, MD
Ralph W. Larkin, PhD


Objectives: Investigate the effects of ischemic compression [IC] technique and
passive stretching [PS] in isolation and in combination on the reduction of spontaneous electrical
activity [SEA] and perceived pain in trigger points [TrPs] located in the upper trapezius muscle.

Methods: Ninety participants with TrPs in the upper trapezius muscle were randomly assigned
to three treatment groups: IC, PS, and IC + PS. TrP compression was applied on the TrP for three
applications of 60 seconds each, followed by a 30-second rest period. PS was applied for three
45-second applications, with 30-second rest intervals. All patients received the same amount of

Results: Significant decreases were found in pain perception and on SEA for all study participants.
The IC + PS group evidenced greater declines in pain perception and SEA when compared
to the IC and PS groups.

Conclusion: Because of ethical considerations, a control group design was not possible, thereby
limiting the robustness of the findings. Although each technique significantly reduced pain perception
and SEA, the combination of IC and PS was superior, apparently because of the complementary
nature of the therapeutic interventions.



Osteopathic Medicine, Cranial Manipulation and Craniosacral Therapy articles.

UPDATED 6/27/2008

Click below to access our


PR & Marketing for the Healthcare Professional

Astoria, NY

January 25-26, 2014
Dallas, TX

Documentation Workshop

November 2-3
Astoria, New York

Manual Therapy scholarship


Hands-On Seminars WEBINARS
  »  Course Registration
  »  Course Sponsorship
  »  Course Descriptions
  »  Seminar Locations
  »  What Is MCMT?
  »  MCMT Quality Standards
  »  Home Study Courses
  »  Videos & Products
  »  Certified Professionals
  »  MCMT Grad Image Gallery
  »  MCMT Platinum Partners
  »  MCMT Gold Partners
  »  Become A Hands-On
      Teaching Assistant
  »  Download Forms
  »  Just Remember
  »  Promotional & Marketing
Subscribe to Journal of Bodywork & Movement Therapies

Journal of Bodywork & Movement Therapies is the Official Journal of Hands-On Seminars.

     Customer Testimonials

As a private practice owner I have realized that the Mastery Certification in Manual Therapy has contributed significantly in building a successful practice image to my community
V. Georgakopoulos, PT, MCMT

View Recent MCMT - Mastery Certification In Manual Therapy Graduates
For Email Newsletters you can trust
Contact Hands-On Seminars - The Leader In Manual Therapy Continuing Education And Publications
Give HOPE now to
someone who needs it!

Contribute now to the
Lymphoma & Leukemia

The PressurePositive Co.

Manual Therapy Live Courses

  View All Live Courses
  Trigger Point Therapy Course PT-01
  Trigger Point Therapy Course PT-01Group
  Cervical Spine Pathology PT-02
  Cervical Spine Pathology PT-02Group
  Lumbar Spine Pathology PT-03
  Lumbar Spine Pathology PT-03Group
  Shoulder Elbow Hand Pathology PT-04
  Shoulder Elbow Hand Pathology PT-04Group
  Hip Knee Foot Pathology PT-05
  Hip Knee Foot Pathology PT-05Group
  Mastery Certification In Manual Therapy
  Neurofascial Mobilization
  Vestibular Rehabilitation
  Fellowship 2 Week Fellowship Program
  Complete MCMT Program Special
Manual Therapy Home Study Courses

  View All Home Study Courses
  Trigger Point Therapy Home Study PT-01HS
  Cervical Spine Pathology PT-02HS
  Lumbar Spine Pathology PT-03HS
  Shoulder Elbow Hand Pathology PT-04HS
  Hip Knee Foot Pathology PT-05HS
Manual Therapy Products

  View All Manual Therapy Products
  Manual of Trigger Point Therapy
  Video of Trigger Point and Myofascial Therapy
  Trigger Point and Myofascial Therapy Posters
  Book Video Poster Combo Special
  Manual Therapy for the Upper Extremity Video
  Manual Therapy for the Lower Extremity Video
  Manual Therapy for the Lumbar Spine Video
  Manual Therapy for the Cervical & Thoracic Spine
  2 Video Discount Pack
  3 Video Discount Pack
  4 Video Discount Pack
  Trigger Point Knobber
Copyright © 2013 Hands-On Seminars © The Leader In Manual Therapy Continuing Education And Publications. All Rights Reserved.